COLUMBUS, Ohio — Receiving a medical bill can often be confusing and concerning, especially when the costs seem unexpectedly high.

Founder and CEO of HealthLock Scott Speranza outlines essential steps that consumers should take to navigate their medical bills effectively and protect themselves from potential financial pitfalls.

The first step after receiving a medical bill is to carefully read your Explanation of Benefits provided by your insurance company. This document outlines what services were covered, what the insurance paid for and what costs you are responsible for. Understanding this information is crucial. Speranza said he advises patients to call their healthcare provider or the lab that issued the bill if they have questions about any charges.

When reviewing your EOB and the bill, don’t hesitate to reach out to your provider with specific inquiries. Here are a few important questions to consider:

• How much did the insurance cover?
• Why do I owe something out of pocket?
• Was any part of my claim denied?

Speranza said about 40% of medical bills contain errors, and a significant 30% of Americans are expected to face denied claims each year. This amounts to around $400 million lost to consumers, making it crucial to be vigilant.

If you find yourself facing overwhelming medical bills, Speranza said he suggests contacting the healthcare facility to arrange a payment plan. This approach can help you manage costs without resorting to high-interest credit cards, which can have rates as high as 29%. In fact, 66% of all bankruptcies are attributed to medical bills, with the statistic rising from 61% pre-COVID, Speranza said. Many individuals fail to plan for medical emergencies, which can result in substantial debt.

Consumers should also be aware of the No Surprises Act, which aims to protect individuals from unexpected medical bills. This legislation prohibits balance billing for emergency services as well as certain out-of-network services provided at in-network facilities. Additionally, it mandates that providers offer good-faith cost estimates to uninsured or self-pay patients. Knowledge of these protections can significantly impact your financial responsibility when receiving care.

Always double-check any denied claims. Claims that are denied — partially or fully — can lead to financial burdens that may cost thousands. Astutely reviewing and appealing these denied claims is essential to ensure you are not held accountable for erroneous charges.

“Those are the ones that could cost us the most money,” said Speranza. “It could be a $10,000, $100,000 or more depending on your care that the bill that you may owe. Those are catastrophic. So make sure that you look out for partial denials and claim denials, and then go ahead and submit appeals, fight those.”